AHCJ Awards

The Awards for Excellence in Health Care Journalism recognize the best health reporting in print, broadcast and online media. The contest is run by journalists for journalists and is not influenced or funded by commercial or special-interest groups.

The contest features a variety of categories and entries can include a wide range of health coverage including public health, consumer health, medical research, the business of health care and health ethics.

Contest entrants fill out a questionnaire that details how they reported the work they are submitting. AHCJ posts those questionnaires with the entries, allowing other journalists to learn about new sources, get story ideas and do similar reporting in their own communities.

Beat Reporting

How could the most ordinary care be so much more expensive in the United States? Why is it so much more costly than in other countries? By examining a series of common medical encounters, "Paying Till It Hurts" dissects the financial incentives and relationships that help create the high prices. The series traces where the money goes.

Judges' comments: Elisabeth Rosenthal shines a light on the absurdities in health care pricing. Something has got to give in this system, and stories like these will inspire people to keep demanding change.

Three of the stories are part of the Journal Sentinel’s ongoing coverage of financial conflicts of interest and how they have affected the practice of medicine in America. The fourth was an installment in the Journal Sentinel’s “Deadly Delays” series on problems in the nation’s newborn screening system. In one story, Fauber learned that one of the nation’s leading experts on how to safely prescribe narcotic painkillers, such as OxyContin, had as many as 20 overdose deaths among patients at his clinic and was under investigation by the DEA. In another story, Fauber introduced readers to the murky new world of “venture philanthropy,” where for-profit drug companies work hand-in-hand with nonprofit charities to develop new treatments, often with the help of taxpayer money. As part of his ongoing investigations of the opioid epidemic, Fauber examined hundreds of pages of emails detailing a decade-long, cozy relationship between drug company executives and regulators at the FDA. Finally, Fauber looked into state medical labs around the country that are charged with testing blood samples from newborns for various dozens of genetic disorders. He found that labs in 27 states were closed on weekends leading to delays in diagnosing diseases that can cause serious symptoms or deaths in babies.

How the U.S. AIDS epidemic has become more and more concentrated in gay black and Hispanic men in their teens and 20s.

An Argentine auto mechanic who invented a simple, safe device to help mothers in obstructed labor give birth.

A little-known tradition at Stanford in which thousands of students get together at midnight under the first full moon and kiss — a custom that raises health considerations the university takes seriously.

Pakistan’s battle against polio in the wake of the murders of numerous vaccinators by the Taliban.

Trade Publications/Newsletters

Health insurance covers drugs approved by regulatory agencies, but it often doesn't pay for the products known as "medical foods" needed to keep individuals alive and well. This lack of reimbursement means that many who cannot afford these life-saving diets suffer brain deterioration and disability — or worse. This news feature reports on the battle for medical foods and how it could affect the treatment of diseases as diverse as osteoporosis and Alzheimer's.

Judges' comments:The reporter details the high price tag and difficulties patients can have securing life-sustaining "medical foods." Khamsi's thorough research, historical context and examination of market economics raises questions about why "medical food" is not considered a drug, and as such isn't covered by insurance companies. Khamsi expertly weaves all of this together to create a compelling narrative about an underreported but important issue.

Genetic testing of the dead for inherited heart rhythm disorders could resolve about one third of sudden death cases that would otherwise remain unexplained – and potentially save lives of surviving family members – if only the tests were used more often. Hearts rhythm disorders kill without leaving a mark, and leave behind a family facing two tragedies, an unresolved death, and perhaps a high risk that that they, too, could succumb to the same fate. Adding to the heartache, the sudden death of a young person with no apparent cause often comes to the attention of law enforcement, and the family comes under suspicion. This issue is fraught with challenges. Blood samples at autopsy that could provide such information are rarely saved. Autopsy thoroughness varies widely across the U.S., from an exam by a county coroner, which likely ends with toxicology, to a full-on workup by a cardiac pathologist that includes the latest genetic analyses. Perhaps the largest hurdle in this complicated issue is finding a way to pay for the genetic testing.

The story explores whether e-cigarettes are a silver bullet for people who want to quit smoking or the latest ploy by Big Tobacco to get more people addicted to nicotine, including kids - how they are characterized will determine how they are regulated and marketed. It took 50 years to find out that cigarettes cause cancer, but we don't have 50 years to find out what the long-term effects of e-cigarettes will be.

And once they enter the lucrative, $30-billion-a-year supplement business, almost anything goes. Criminal turned supplement entrepreneurs have repeatedly put risky products on the market through a changing series of companies as overwhelmed regulators struggled to keep up. Their pills and powders have included everything from a sleep-aid laced with a powerful anti-psychotic drug, to a widely sold workout supplement spiked with a methamphetamine-like chemical never before tested on people.

Judges' comments: With exhaustive and groundbreaking reporting, Alison Young laid bare the hazards posed by dietary supplements taken by thousands of American consumers. Young followed supplement makers through the courts and to Mexico, spoke truth to big distributors like Walmart, government regulators and other in the industry, and demonstrated that there is little effective control over the contents of highly popular and widely distributed supplements. And she got results: Walmart has removed Craze, an energy supplement, from its shelves. Florida investigators are looking into the past of some of the supplement makers. The industry has also taken action.Young’s work represents the best in journalism: A topic that affects a large swath of the population. Original and thorough reporting. Excellent writing. Great multimedia presentation. Impact.

In contrast to other reports on assisted living, this story closely scrutinized the internal mechanics of the nation’s largest provider, Emeritus Senior Living, which is emblematic of the industry’s transformation from grassroots movement to major industry. It reported on the company’s intense drive for profits and cases of suffering of frail seniors in its roughly 500 facilities, revealing for the first time the circumstances surrounding the death of George McAfee, an NFL Hall of Famer with dementia who died after accidentally drinking poisonous dishwashing liquid in what was supposed to be a safe, secure building.

Indian generic-pharmaceutical company Ranbaxy pleaded guilty to seven federal criminal counts of fraud and other charges and agreed to pay $500 million in fines and penalties. “Dirty Medicine,” based on more than 1,000 confidential company documents and interviews over several years with Ranbaxy staffers, takes readers deep inside the boardroom, offices and labs at the company. ReporterKatherine Eban deciphered reams of complex laboratory documents to learn how the company routinely fabricated tests for its drugs. By obtaining secret company documents, she exposed how Ranbaxy’s top leadership was complicit in the worldwide fraud. Eban’s reporting revealed how ill-equipped the U.S. Food and Drug Administration is to detect the sort of wholesale fraud that Ranbaxy practiced, raising deeply upsetting questions about the safety of the entire U.S. drug supply, which is now 84 percent generic, most of it made overseas.

Business (small)

Articles looked at why a targeted cancer drug failed, despite evidence that it was effective, challenged the world's leading drugmakers to make a more serious move to disclose all of their clinical trial results, debunked much of the present hype around big data in health care, while showing how it could be usefully applied in the future, and explained an important new change to drug regulatory policy at the FDA.

Judges' comments: Original, incisive and engaging pieces founded on a deep understanding of how the intricate business of health care works.

Nonprofit foundations for diseases are funding for-profit companies to research treatments and potential cures for their disorders, a trend called "venture philanthropy." Not only are they funding research, they are doing so with a businesslike focus on meeting goals and milestones and, in some cases, with revenue from the resulting drugs being funneled to the foundation for further research. Can these nonprofits be transparent enough to reassure stakeholders that they are not operating on the same capitalist model as pharmaceutical and biotech companies? For instance, the biggest success from venture philanthropy so far is Kalydeco, a new drug that treats 4 percent of cystic fibrosis sufferers with what has been described as a functional cure, developed with funding from the Cystic Fibrosis Foundation. The cost of the drug is high and there are questions about how ethical it is for the CFF to be receiving royalties from its sale.

Memorial Hermann, the largest nonprofit in Houston, was pursuing lawsuits in civil court against uninsured patients who failed to pay. The story highlights how some medical systems are called nonprofits even though the systems don't function like nonprofits, to the point of suing poor and uninsured patients.

Investigative (large)

Nearly every baby born in the United States has blood collected within a day or two of birth to be screened for dozens of genetic disorders. Each year, newborn screening is credited with saving or improving the lives of more than 12,000 babies in the United States. The entire premise of newborn screening is to detect disorders quickly so babies can be treated early, averting death and preventing or limiting brain damage, disability and a lifetime of costly medical care.

The Milwaukee Journal Sentinel found that thousands of hospitals — and dozens of state agencies that oversee the programs — are failing America’s children due to an ineffective and unaccountable newborn screening system wracked by deadly delays. As a result, children who should be diagnosed and treated shortly after birth are suffering preventable brain damage, disability and even death — as if they had been born decades before today’s screening tests and treatments were available.

Judges' comments: This team dug into reams of hard-to-acquire state data to find that thousands of hospitals have been failing to screen newborns for genetic diseases, putting those children at risk of serious illness or death. And the government was failing to hold them accountable. We were impressed with how the reporters made this both a local and a national story. Although the reporting was data-driven, the stories of the lives destroyed left a heavy emotional impact on the reader. The series was deeply reported, precisely edited and engagingly packaged. The results were profound: Confronted with data about their own nonperformance – numbers some had never seen before – hospitals immediately acted to improve. Health associations, states and even Congress took action to better monitor the timeliness of newborn screening which, thanks to the series, is poised to become an official measure in the hospital accreditation process.

An investigation by USA Today reporter Alison Young revealed that a wide array of dietary supplement companies selling products dangerously spiked with hidden pharmaceuticals are headed by executives with criminal backgrounds and run-ins with regulators. They’re convicted felons, thieves, drug addicts, narcotic sellers and more, the reporting revealed. And once they enter the lucrative, $30-billion-a-year supplement business, almost anything goes. Criminal turned supplement entrepreneurs have repeatedly put risky products on the market through a changing series of companies as overwhelmed regulators struggled to keep up. Their pills and powders have included everything from a sleep-aid laced with a powerful anti-psychotic drug, to a widely sold workout supplement spiked with a methamphetamine-like chemical never before tested on people.

Since July 2008, Rawson-Neal Psychiatric Hospital in Las Vegas has transported more than 1,500 patients to other cities via Greyhound bus, sending at least one person to every state in the continental United States, according to a Bee review of bus receipts kept by Nevada's mental health division.

Investigative (small)

In 2013, after a decade of war, the Army was kicking out more soldiers than ever before for minor misconduct, including injured combat veterans. Among combat troops, these other-than-honorable discharges had surged more than 67 percent since 2009. Many of these troops had so-called “invisible injuries” such as traumatic brain injury and post-traumatic stress disorder that made them more likely to get in trouble. An other-than-honorable discharge stripped them of VA benefits for life, which meant the troops who needed help the most were least likely to get it.

Judges' comments: This series brought to life a little-known form of Army discipline that has left thousands of veterans without medical benefits as they suffer the effects of fighting for our country. The stories provided example after example of outrageous cases, prompting changes at the local, state and federal levels.

This special report broke the story of a public health crisis affecting hundreds of thousands of people: a nationwide shortage of IV nutrients so drastic that hospitals were hoarding, rationing, and bartering them in order to keep patients from dying. Across the country, patients were developing nutrient deficiencies severe enough that doctors were seeing complications normally found only in the developing world.

Robbins found discrepancies in FDA statements and delved into medical mysteries, U.S. and foreign drug policies, and the complicated economics of sterile drug manufacturing to determine how these problems could happen in 21st-century America when they were not happening abroad. Robbins also wrote a follow-up article to bring the issue to the attention of a different demographic of readers. She traced the sources of IV nutrients used for non-medical cosmetic IVs that celebrities (and others) purchased to look better before photo shoots or to treat hangovers. Her investigation revealed that the popular “vitamin drip” trend was indeed using resources that hospital and home care patients desperately needed.

A months-long investigation by EHN revealed that scientists who have criticized plans in Europe to regulate hormone-disrupting chemicals have past or current financial ties to regulated industries. The stakes are high in the controversy because it involves the European Union's strategy to regulate these chemicals – the first attempt in the world to do so. The new rules would have sweeping, global ramifications for companies that manufacture or use high-volume substances such as bisphenol A. The investigation showed that the scientists (all editors of science journals) who attacked the EU plan have collaborated with chemical, pharmaceutical, cosmetic, tobacco, pesticide or biotechnology companies.

Consumer/Feature (large)

Overdose is the first full accounting of the damage done by acetaminophen – a medicine marketed for its safety – and the failings of federal officials to act as they confronted increasingly definitive evidence of its danger. The first piece detailed the narrow margin for error in administering acetaminophen, a concern that first surfaced in the late 1970s. They established that McNeil Consumer Healthcare, the unit of Johnson & Johnson that makes Tylenol, had fought for decades against measures meant to safeguard users and that the FDA’s inaction continued for decades The second major piece in the series used the tragic tale of the Hutto family to show how McNeil and the FDA had delayed acting for years to tackle a well-known medical mix-up that had resulted in an untold number of deaths and injuries to infants and children’s over the decades. The third major piece showed how a simple safety valve called a flow restrictor could prevent up to 10,000 visits per year to the emergency room for kids who accidentally get into liquid medicines.

Judges' comments: Exhaustive reporting, concise writing and heartbreaking videography on a health topic that affects a vast swath of the public all combine to make this ProPublica package a clear winner. More than 10,000 pages of FDA documents, court records and scientific journals going back decades were reviewed for this project, which demonstrates federal and corporate failures to keep families safe from liver failure and death that can be caused by miscalculating safe doses of the over-the-counter drug acetaminophen.

In contrast to other reports on assisted living, we closely scrutinized the internal mechanics of the nation’s largest provider, Emeritus Senior Living, which is emblematic of the industry’s transformation from grassroots movement to major industry. We reported on the company’s intense drive for profits and cases of suffering of frail seniors in its roughly 500 facilities, revealing for the first time the circumstances surrounding the death of George McAfee, an NFL Hall of Famer with dementia who died after accidentally drinking poisonous dishwashing liquid in what was supposed to be a safe, secure building.

This feature story follows a group of six first-year students at the Medical College of Wisconsin through the most pivotal course in their quest to become doctors: Gross anatomy. The story takes readers into a world that few will ever know, one where youthful caffeine-chugging doctors-to-be are forced to rethink their goals and ambitions, their views of medicine and the role of doctors, of life and death and what follows. “The Course of Their Lives” ties together the mystery facing the medical students of Table 1 as they struggle to determine what killed the woman whose body they are working on, and story of 80-year-old Geraldine “Nana” Fotsch and how she came to the decision to one day donate her body to be examined by a similar group of students.

This NPR series explores one of the hottest fields of scientific research today: the "human microbiome." Scientists increasingly believe that the trillions of microbes that live in and on the human body play crucial roles in our health and well-being. The bacteria, viruses, fungi and other microorganisms inhabiting the human body help keep us healthy and may contribute to making us sick when they get disturbed. In a six-part series, NPR Correspondent Rob Stein explains how scientific thinking shifted from assuming microbes were generally our enemies to appreciating that many are more friend than foe.

Consumer/Feature (small)

"State of Despair" focused on Montana's epidemic suicide rate, which is twice the national average with more frequent suicides than any other place in the nation. Montana Sen. Max Baucus referenced the series on the floor of the U.S. Senate as he discussed what the government was doing to help curb the rising number of military suicides. One of the most significant findings of the series was that one of the highest rate of suicides in the state was among the elderly, not teenagers, as we suspected when we started the series. All the anecdotal evidence pointed to the suicide rate being highest among teens.

Judges' comments:Cindy Uken’s series on Montana’s sky-high suicide rates was a journalistic tour de force: comprehensive, honest and compassionate. Digging into the appalling statistics, she showed how the elderly, not teens, were most likely to kill themselves. Again and again, Uken succeeded in getting survivors and their relatives to tell their stories, no easy feat given the subject matter.

Only one-quarter of adults in New Hampshire have completed advance directive forms, also called living wills, despite efforts by legislators, health care workers and advocates to increase their use. One problem is an outdated, confusing form prescribed in state law that slows the process and, on occasion, precludes out-of-state advance directives from being honored in medical facilities in New Hampshire. This series looked at changes being made to the form, the controversial history of end-of-life care, and also investigated why people remain hesitant to complete the document. It also highlighted some successful efforts around the state to get conversations around death and dying started. The final piece looked at the convoluted legal process some families find themselves in when loved ones haven’t left clear direction for their medical wishes. The stories shared viewpoints of families and doctors facing end-of-life decisions, as well as the pressure health care proxies can face in carrying out those desires.

An overview of the process and status of organ donation and transplantation in Louisiana. Karen Stassi reports that the percentage of Louisiana adults that are registered as organ donors, as well as the per capita number of actual donors, far outstrips rates in most of the country and indeed the world. Louisiana’s rate of approximately 35 deceased donors per million population is similar to Spain, which boasts the highest rate of any country in the world. At the same time, in Louisiana about 1,700 people are waiting for organ transplants, 90 percent of them for kidneys.

Health Policy (large)

This series of stories explored the regulatory and legal twists and turns and illustrated how poorly prepared elderly care facilities, regulators and families are for dealing with older people with dementia who want – and have a legal right – to have sex. They begin with a story of a 78-year-old man and an 87-year-old woman, both with dementia, were found having sex. The home’s administrator and nursing director were fired and the man was forced to leave. The next story illustrated the same dilemmas in reverse with a look at a facililty that has had a written sexuality policy since 1995. And the third story reported exclusively that the AMDA, an organization that represents the medical directors who advise the nation’s 16,000 nursing homes, was urging facilities to consider adopting sexual policies and training.

Judges' comments: Sex is important, but hard to talk about. Our parents having sex is harder to talk about. Policies about consent for sex between elderly people with dementia in care facilities are monstrously difficult to devise. Not surprisingly, coverage of the subject is rare. This series did not shrink from these challenges, offering fresh perspective on an under-reported topic. With careful reporting and balanced writing that delicately navigated clashing positions of science, morality and regulation, this series not only revealed the trauma that can result from sexual encounters between dementia patients, it sparked public awareness and an industry association response that encourages better policies and more training.

This investigation explored why mental health care in Milwaukee County, Wis., is especially ineffective. It found that Milwaukee politicians – for decades – have ignored calls for reform. Doctors are bound by the strictest time constraints in the country, allowing them 24 hours to observe patients considered dangerous., and a data analysis found that people returned for care at an alarming rate. One woman had been seen 196 times in six years, an average of once every 11 days. A big part of this project was to identify ways that the system could improve, requiring travel to other places to look at communities that do a better job.

Overdose is the first full accounting of the damage done by acetaminophen – a medicine marketed for its safety – and the failings of federal officials to act as they confronted increasingly definitive evidence of its danger. The first piece detailed the narrow margin for error in administering acetaminophen, a concern that first surfaced in the late 1970s. They established that McNeil Consumer Healthcare, the unit of Johnson & Johnson that makes Tylenol, had fought for decades against measures meant to safeguard users and that the FDA’s inaction continued for decades The second major piece in the series used the tragic tale of the Hutto family to show how McNeil and the FDA had delayed acting for years to tackle a well-known medical mix-up that had resulted in an untold number of deaths and injuries to infants and children’s over the decades. The third major piece showed how a simple safety valve called a flow restrictor could prevent up to 10,000 visits per year to the emergency room for kids who accidentally get into liquid medicines.

Health Policy (small)

Using the development of IBM's "Watson" computer as a peg, the article considers whether we are on the cusp of a major revolution in medical care – and, if so, whether it would be a change for better or worse. A catalyst for this revolution will be health care reform and the pressure it applies on providers to deliver care at lower costs. In theory, this revolution could help professionals deliver better care – and it could help patients to stay healthy, so they never need medical care. History is littered with examples of such transformations not happening – particularly in health care. And what are the possible downsides? Will insurers use this technology to skimp on care, for example? The article explores these questions, by taking a close-up look at some of the innovations, panning back to see how medical care might already be changing, and then exploring the implications for policy-makers.

Judges' comments: Jonathan Cohn's "The Robot will See You Now" broke new ground in assembling a broad picture of the promising, disruptive power of data and computing technology to improve health care delivery and control its cost. Exhaustive reporting and the unusual clarity of Cohn's writing made an unfamiliar, complex subject easily accessible – and fascinating – to the general reader.

Second Place: Bitter pills; John Ramsey, The Fayetteville (N.C.) Observer

This five-day series on prescription painkillers set out to explain why and how a national problem is intensified in Fayetteville, N.C., home to the world’s largest Army installation and a large VA Medical Center. Reporter John Ramsey found that prescription painkillers contributed to 95 deaths in Cumberland County between 2008 and 2011, more than the previous eight years combined. At the Fayetteville VA Medical Center, prescriptions for the painkiller hydrocodone spiked by 4,100 percent from 2000 to 2011. The total number of prescriptions for the powerful painkiller oxycodone rose 272 percent in the Fayetteville region. Along with the surge in prescriptions came a new wave of addiction, crime and overdose deaths.

This is an occasional series that examines how the Affordable Care Act is impacting the people, patients and health care providers of southwest Virginia. Each installment of the series was based on the story of a local resident, weaving personal experiences with the policy implications of a variety of elements of the ACA: The proposed Medicaid expansion in Virginia, the insurance marketplaces, the individual mandate, outreach efforts by navigators, problems with the marketplace website, how a physician shortage could grow worse under the law, and a look at how people with pre-existing conditions will benefit from the law.

Public Health (large)

Correspondents across Africa and Asia examined what works and what doesn’t in the battle to end the nearly 7 million preventable child deaths that occur each year around the world. Reporters were dispatched to India, Bangladesh, Uganda, Zambia and Myanmar. The multimedia series brought to light untold stories from the most hard-to-reach places: the effects of corruption on malaria control in Uganda, the tension between pneumonia treatment and prevention in Zambia and the shortcomings of neonatal care in India. Investigative pieces from Washington documented how budget cuts threaten global health spending and how a well-intentioned global campaign to end child deaths has been hindered by a lack of coordination and funding.

Judges' comments: A vast and extraordinarily informative survey of child mortality around the world. The scope of the staff reporting is breath-taking and the variety of media used to tell the story make it all the more compelling. Particularly effective was the interactive map showing the number of deaths before age 5 per population for nearly every country in the world. Much of the series is grim but a note of optimism pervades because the survey points to relatively simple fixes in many areas if the public will is there. This report will go a long way toward galvanizing that will.

This series of articles looks at how doctors practice medicine and intensive marketing by the pharmaceutical industry have made the diagnosis of ADHD, and the prescription of drugs with significant risks, alarmingly common.

This is an eight-part series examining why life expectancy doubled in the past 150 years. Coverage examines public health initiatives that contributed to the increase, how increased life expectancy changed human society, and death in childbirth and the fight to this day between doctors and midwives. The fourth piece is a quirky list of surprising innovations that increased life expectancy. One piece examines the debate about whether lifespan will continue to increase. An interactive game allows people to go back to a certain year in time, spin the wheel of fate, and see how they likely would have died in that year. A video story presents song/comedy routine send-up of mindless alternative medicine. Finally, the series ends with a collection of readers' emails and Twitter messages about why they aren't dead yet.

Public Health (small)

The world is close to eradicating polio, but Nigeria, one of just three endemic countries in the world, stands in the way. Children in Nigeria continue to be needlessly paralyzed by a vaccine-preventable disease, and the virus from Nigeria has repeatedly jumped borders and has reinfected more than 20 countries that were previously polio-free. Science spent three days on the road with Nigeria's then-minister of state for health, chronicling his surprisingly personal effort to finally chase the virus from his country.

Judges' comments: Leslie Roberts skillfully explored a widely misunderstood public health story – why is it that many Nigerians refuse to allow their children to be vaccinated against polio? While making the global health implications clear, the article took us to the front lines, where workers (some of whom have died in the effort) encounter people who have so many unmet needs, it is hard for them to comprehend why this one vaccination is the only health measure provided. The piece also offered insight into how Nigeria's minister of state for health appears to be succeeding where so many have failed – while noting that he is stepping away from leading this fight.

Although Type 2 diabetes long has been a problem in Corpus Christi, Texas, the community has failed to find sustainable solutions to the epidemic. Meanwhile, one in six people have the disease and non-traumatic below-the-knee amputation rates are among the highest in the nation. The Corpus Christi Caller-Times embarked on a yearlong series, led by reporter Rhiannon Meyers, to find out why Type 2 diabetes and the rates of diabetes-related complications remain so persistently high; what effect has there been on residents, economy and health care, what can be done about the problem and to educate the public.